Researchers have been trying to find solutions to workplace bullying for decades. Healthcare organizations have been implementing strategies to reduce lateral violence so that nurses will be retained and patient care will be improved. The purpose of this study was to determine if new graduate nurses continue to experience the negative acts of lateral violence. This study will bring awareness to the lateral violence that occurs in organizations and will aid in future plans and techniques to prevent lateral violence towards new graduate nurses.
Study Design
This study used descriptive analysis to summarize and show the relationship between the quantitative data.
Setting and Sample
The study was conducted at a 1,004 bed, non-profit, acute medical center in North Carolina. The facility is an academic medical center offering services such as level one trauma center, pediatric trauma center, comprehensive cancer center, heart and vascular center, neurology and neurosurgery, rehabilitation and psychiatric care. The facility is also home to some of the world’s foremost biotechnology, materials science, and information technology research. The study’s sample included nurses who had been in the profession for one year or less and worked at the acute care medical center.
Exclusion criteria included any nurse who had been in the profession for more than one year.
Design
Registered nurses who have been in the profession for one year or less were invited to participate in the survey via their facility email address. A link was provided which took them to Survey Monkey where they could complete the survey. The informed consent letter was presented to them upon entering the link. It included the purpose of the study, and that participation was strictly voluntary. It informed the participants that they could stop the survey at any time with no penalty. The informed consent also told the participants that the survey was confidential and only information needed to assess study outcomes would be collected. The Negative Acts Questionnaire- Revised (NAQ-R), a 23-item Likert style questionnaire was used as the study tool. The survey took 15-30 minutes to complete. Willingness to answer the survey was
considered consent. The results were stored on a password protected computer which only the research team had access to, and included a principle investigator and one research assistant. The survey was anonymous with no identifying information. The survey was open for 14 days to allow as much participation as possible. Electronic communication was sent out weekly to remind participants of the survey. Flyers were sent to the nursing education department to be distributed in Journey’s, the hospitals new graduate nurse program. These flyers included the purpose of the survey, that the survey was voluntary, and confidential.
Measurement Methods
The tool used was the Negative Acts Questionnaire-Revised (NAQ-R) (Einarsen et al., 2009). An email was sent to Staale Einarsen, the author of the NAQ-R asking permission to use the survey. Permission was granted to use the survey tool from Oystein
Hoprekstad, research assistant to Staale Einarsen, on February 24, 2015. The NAQ-R consists of 25 questions. The first 22 questions are five point Likert style with the options of never, now and then, monthly, weekly, or daily. These questions ask the participants if they have experienced any of the behaviors that would indicate lateral violence. These behaviors include but are not limited to: withholding information, being humiliated, having gossip or rumors spread, being ignored, having threats of violence made, or being shouted at. Question 23 asks whether the participant has been bullied over the last six months. Question 24 is a select all that apply question, asking who the participant has been bullied by. Question 25 asks how many of the participant’s bullies are male or female. The validity and reliability of the survey were tested and measured. The original study was analyzed using Cronbach’s alpha which was 0.90, indicating excellent internal consistency. The authors of the survey also used RMSEA, CFI, and GFI to test the underlying dimensions. All of the analysis showed greater than 0.70 with no error correlations. Pearson’s, and Spearman’s showed positive correlations. These analyses combined proved the reliability and validity of the NAQ-R to measure the exposure of workplace bullying.
Data Collection Procedure
The survey was put into Survey Monkey, an electronic survey program. The nurses who met the inclusion criteria of being in the profession for one year or less were sent an email explaining the study and a copy of the informed consent was provided through the link. The informed consent stated the purpose of the study, that participation was voluntary, and explained the confidentiality of the survey. They were asked to take the survey online through a link provided in their email. The survey was open for 14
days to allow for as much participation as possible. Once the survey closed, Survey Monkey provided a basic analysis of the data.
Protection of Human Subjects
Approval for the study was obtained from the medical center Internal Review Board (IRB) as well as the university IRB. Once participants were identified, they were sent an invitation through their medical center email. The email provided a secure link to the Survey Monkey website. Once there, they were presented with an informed consent. The informed consent letter included the purpose of the study, that participation was strictly voluntary, and that the participant could stop the survey at any time with no penalty. The informed consent also told the participants that the survey was confidential and only information needed to assess study outcomes would be collected. The results of the survey are stored on a password protected computer which only the research team, which includes the principal investigator and one research assistant has access to. The survey was anonymous with no identifying information.
Data Analysis
The study data was analyzed using Survey Monkey which provided a basic analysis once the survey was complete. The research assistant entered the data into Survey Monkey. The study used descriptive analysis to summarize and show the relationship between the quantitative data.
CHAPTER IV Results
This research study was done to examine if new graduate nurses experience negative acts of lateral violence. The invitation to the survey was sent via email to the qualified participants. Included in the invitation was a link to Survey Monkey where participants could complete the survey. The data received was then used to answer the research question.
Sample Characteristics
One hundred and sixty survey invitations were sent out electronically through the email of the research facility to nurses who have been in the profession for one year or less. Demographics were not included in the survey to maintain confidentiality.
Major Findings
Thirty five surveys were completed for a response rate of 22%. There were seven questions of the first 22 questions which were answered fully. The other 15 questions had 34 answers. Question 23 was fully answered by all 35 respondents. Question 24 had six answers therefore 29 skipped this question. Question 25 had nine answers therefore 26 skipped.
Participant’s responses were evaluated to determine whether new graduate nurses who have been in the profession for one year or less have experienced negative acts of lateral violence. The first 22 questions ask about specific acts of lateral violence. These were rated on a five point Likert scale with the options of never, now and then, monthly, weekly, or daily, see Figure 3 below.
Question 23 asked if participants had been bullied at work over the last six months. Thirty (85.71%) said no, one (2.86%) said yes, but only rarely, three (8.57%) said yes, now and then, one (2.86%) said yes, several times per week, and one said yes, almost daily. This question was fully answered. Question 24 asked participants who bullied them. Zero said my immediate supervisor, or other supervisors, four (66.67%) said colleagues, one (16.67%) said subordinates, zero said customers/patients/students, and one (16.67%) said physicians. This question was skipped by 29 participants. Participants of the survey stated of their bullies, 17 were female and two were male.
Summary
The participant’s responses were evaluated to determine whether new graduate nurses who have been in the profession for one year or less have experienced negative acts of lateral violence. The majority of new graduate nurses stated they have never experienced the negative acts of lateral violence. The top four acts that were experienced by new graduate nurses were being ordered to do work below you level of competence (32.35%), being ignored or excluded (34.29%), having your opinions and views ignored (29.41%), and being exposed to an unmanageable workload (44.11%).
CHAPTER V